The Private Healthcare Insurance sector: A victim of fraud

Regardless of the jurisdiction research has repeatedly highlighted that the ‘public’ see the insurance sector as an acceptable business to defraud. This article builds on this work but is different in that we draw on primary research, of which there is little, into the private healthcare insurance sector as a victim of fraud. We start by highlighting the types and volumes of fraud that the insurance sector encounters. This is followed with an examination of policing private insurance fraud in a neo-liberal context where individuals and organisations are responsible for risks. Then, we consider if the private healthcare insurance sector is precipitating and participating in its own victimisation. The methods used in this research to secure data are then explained. Finally we analyse how the key elements of the data might point to the private healthcare insurance sector potentially precipitating and participating in its own victimisation.

The Clinical and Economic Effectiveness of MyDiaCare, Digital Tools combined with Diabetes Nurse Educator Support, for managing Diabetes in South Africa (Preprint)

BACKGROUND In South Africa, diabetes prevalence is expected to reach 5.4 million by 2030. Moreover, a large proportion of adults remain undiagnosed. In South Africa, diabetes-related complications not only severely impact patient health and quality of life, but also the economy. OBJECTIVE The Diabetes Nurse Educator (DNE) study assessed the benefit of adding the MyDiaCare program to standard of care for managing type 1 and 2 diabetes patients in South Africa. An economic study was also performed to assess the benefit of adding MyDiaCare to standard of care in type 2 diabetes patients, older than 19 years, treated in the South African private healthcare sector. METHODS The real-world DNE study was designed as an observational, retrospective, multicenter, single group study. Eligible patients were older than 18 years and with at least 6 months of participation in the MyDiaCare program. The MyDiaCare program combines patient mobile application and a healthcare professional platform with face-to face visits with a DNE. The benefit of MyDiaCare was assessed by the changes in HbA1c levels, the proportion of patient achieving clinical and biological targets, adherence to care plans, and satisfaction after 6 months of participating in the MyDiaCare program. A budget impact model was performed using data from the DNE study and another South African cohort to estimate the economic benefit of MyDiaCare. RESULTS Between 25 November 2019 and 30 June 2020, 117 patients (8 with type 1 diabetes and 109 with type 2) were enrolled in two centers. After 6 months of MyDiaCare, a clinically relevant decrease in mean glycated hemoglobin (HbA1c) levels by 0.6% from 7.8% to 7.2% was observed. Furthermore, 54% of patients reached or maintained their HbA1c targets at 6 months. Most patients achieved their targets for blood pressure (67% for systolic and 89% for diastolic blood pressure) and lipid parameters (69% for low-density lipoprotein (LDL) cholesterol, 58% for high-density lipoprotein (HDL) cholesterol, and 83% for total cholesterol, but fewer patients for triglycerides (46%), waist circumference (18%), and body weight (17%). The mean overall adherence to the MyDiaCare care plan was 93%. Most patients (74%) were satisfied with the MyDiaCare program. The economic study estimated that after 1 year of using the MyDiaCare program, the cost of type 2 diabetes management in the South African private healthcare sector would be reduced by 26 billion rands: from 117 billion rands with standard of care to 91 billion rands by adding MyDiaCare. CONCLUSIONS The MyDiaCare program, that combines digital tools for patients and healthcare professionals with DNE support, is a practical, clinically effective (lowering HbA1c levels and other cardiovascular risk factors), and cost-saving solution for diabetes management in the South African private healthcare sector. CLINICALTRIAL Not applicable.

Applications of lean in human resources management in healthcare

Recent challenges brought by the coronavirus disease-2019 pandemic have underscored the importance of coping with pressures on the workforce in healthcare around the world and have emphasised the continuing need to improve quality and operation efficiency of healthcare services even in such dire circumstances. Over the years, lean thinking has gained recognition in the healthcare industry, where lean has been associated with benefits, such as improved healthcare delivery quality, reduced costs and increased effectiveness of the healthcare delivery processes. Lean thinking has also been analysed in human resources with benefits, such as increased job satisfaction and perceived job autonomy. The current narrative review was planned to analyse and discuss the application and implementation of lean strategies with a particular focus on human resource management in healthcare. The review is complemented by a case study in a private healthcare group in Turkey, ---Continue

Analysis of the main indicators of dental care in Ukraine for 2020

The article presents an analysis of the results of state and sectoral statistical reports of dental healthcare institutions, which were submitted to the State Institution “Center for Medical Statistics of the Ministry of Health of Ukraine” in 2020. As of January 1, 2021, 22,180 general dental practitioners and 766 dentists provided dental care to the population of Ukraine in 6,443 institutions of various forms of ownership. The article pre-sents the structure, staffing level and dentistry personnel density in Ukraine; also, a comparative analysis for the last 5 years was conducted in terms of staffing level of dentists working in healthcare institutions of different forms of ownership. The main indicators of the system of providing dental care in both public and private healthcare facilities are presented. A comparative analysis with the main indicators of dental care for 2019 was carried out. The number of routine examinations of the oral cavity decreases and the number of malignant neoplasms, especially advanced ones, increases.

Challenges Faced by Healthcare Professionals during the COVID-19 Pandemic: A Review

Introduction: On March 11, 2020, the WHO formally declared the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks a pandemic by publishing public health guidelines to guide pandemic response. Serious illnesses may necessitate hospitalization and ventilatory assistance. The pandemic of coronavirus disease 2019 (COVID-19) has posed new concerns for healthcare workers around the world. However, in many developing nations, including India, information is scarce concerning these issues. Healthcare facilities are one-of-a-kind and difficult to understand. The Indian healthcare system consists of both governmental and private healthcare facilities. Healthcare practitioners face a variety of obstacles daily. The unexpected appearance of COVID-19 created a new threat to an already overburdened healthcare system. The pandemic altered the healthcare dilemma by introducing new employment and societal obstacles to healthcare workers. The goal of this review research is to uncover the causes of the workplace and societal issues that healthcare workers encounter.

Mobile Health Technologies could enhance Public Private Mix for Tuberculosis care in Rural Southwestern Uganda: Qualitative Findings

Background Despite some global progress in the implementation of the public-private mix for Tuberculosis care, the engagement of private healthcare providers remains wanting especially in high incidence countries such as Uganda. Although mobile health technologies are low-cost approaches that can enhance Tuberculosis care, there is a dearth of research about their application in fostering public-private mix. Objective To explore the potentials of mobile health technologies in fostering public-private mix for Tuberculosis care in Uganda. Methods This was a qualitative study design that involved in-depth interviews with 13 key informants (private healthcare workers) purposively selected between June and July 2020 due to their active involvement in Tuberculosis care from four private hospitals in Mbarara City. The interviews were transcribed and coded to identify key themes for analysis using content analysis. Results Mobile Health technologies (such as mobile apps, text messages) have the potential to map and link patients from private hospitals to the referral units, support patient medication adherence, notify and report Tuberculosis cases to the Ugandan Ministry of Health, and enhance patient care and monitoring. Conclusion Mobile Health technologies have the potential to revolutionize Tuberculosis care by establishing a centralized pathway for linking the referred patients from private hospitals to public hospitals. Future research should focus on assessing the utilization of mobile health technologies in enhancing access to referral units by presumptive Tuberculosis patients referred from private hospitals in low-resource settings.

On the problem of human resources in ukrainian private health care

The article is devoted to the scientific analysis of human resources in the healthcare system of Ukraine, particularly in the private sector. The study is specifically concerned with the current staffing of the healthcare system of Ukraine with doctors and junior specialists with medical education. We analyzed the ratio of the main quantitative indicators of medical workforce in healthcare institutions of different forms of ownership, as well as the dynamics of indicators representing involvement of doctors of different specialties in the private healthcare practice. Acute issues concerning workforce in the private healthcare sector were identified and analysed, with a matter of pressing concern being inferior quality of professional training provided for medical staff. This research was aimed at substantiating the role of the state human resource policy in healthcare system and examining the political measures taken by the government in order to develop medical education and science, and to increase healthcare workforce potential. Conclusively, we formulated proposals regarding appropriate solutions to the human resource problems of the private healthcare service providers in Ukraine.

Unresolved symptoms in adult population after mild SARS-CoV2 infections

Introduction. The coronavirus disease (COVID-19) in the past year and a half has become a worldwide pandemic. COVID-19 symptoms, severity and duration vary widely, with an increasing number of cases of unresolved and prolonged symptoms. Objectives. This study aims to characterize unresolved symptoms of mild COVID-19 patients for a period of five months after disease onset, and potentially aid in disease management. Methods. Seventy-five adult patients were involved in the study in the period October 2020- March 2021 in Eurofarm Centre Private Healthcare. Inclusion criteria required patients to be aged ≥18 years, with positive SARS-CoV2 PCR test results and non-severe symptoms which did not require hospitalization. The onset, duration and resolution of symptoms were analysed.